Individual
REGINALD A GIVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1401 E STATE ST, ROCKFORD, IL 61104-2315
(815) 489-4123
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036093992
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093992
—
IL
Enumeration date
11/10/2006
Last updated
03/08/2021
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